颈动脉斑块及主动脉脉压与冠状动脉病变严重程度的相关性及预测价值  

Relevance and predictive value of aortic plaque and aortic pulse pressure to degree of coronary disease

作　　者：马林业 骆金玺 魏琦 高传玉[2] 

机构地区：[1]许昌市人民医院心内科,河南许昌461000 [2]河南省人民医院心内科,河南郑州450003

出　　处：《心脏杂志》2010年第4期569-571,575,共4页Chinese Heart Journal

摘　　要：目的:探讨颈动脉斑块及主动脉脉压(PP)与冠状动脉病变严重程度的相关性和预测价值。方法:将276例均行冠脉造影、主动脉压测量、颈动脉超声的患者资料回顾性分析,根据有无颈动脉斑块和PP水平≥或<65 mm-Hg分为4组:无颈动脉斑块+PP<65 mmHg组,无颈动脉斑块+PP≥65 mmHg组,颈动脉斑块+PP<65 mmHg组和颈动脉斑块+PP≥65 mmHg组,进行比较分析。结果:4组间年龄、血压、血脂有显著差异(P<0.05,P<0.01);多元线性逐步回归分析显示:年龄、PP、颈动脉斑块与冠脉积分正相关;颈动脉斑块和PP增大预测冠脉病变严重程度的敏感性为81%vs.77%、特异性为93%vs.91%、阳性预测值为57%vs.51%和阴性预测值为98%vs.97%,二者结合可提高敏感性(90%)和阳性预测值(77%,均P<0.05)。结论:颈动脉斑块联合PP可更好地预测冠脉病变严重程度。AIM： To evaluate the effect of super-selective intracoronary injection of nitroprusside on no-reflow phenomenon of primary percutaneous coronary intervention （PCI）. METHODS： Forty-three acute myocardial infarction （AMI） patients with no-reflow phenomenon after primary PCI were included in the study. Super-selective intracoronary infarction related artery （IRA） injection from ZEEK thrombus aspiration catheters was used in 21 cases, and routine injection from guiding catheter was used in the other 22 cases. Nitroprusside was injected （100 μg） by 2-sec bolus in both groups. Coronary arteriography （CAG） was rechecked 10 min after injection, and TIMI as well as CTFC of IRA blood flow were evaluated. RESULTS： No-reflow phenomenon was markedly relieved in both groups. All cases in the super-selective group restored TIMI III blood flow and CTFCs of IRA decreased from 83.7±7.02 to 26.5±5.81 （P〈0.001） after super-selective intracoronary injection of nitroprusside, whereas those in the routine group decreased from 84.5±6.45 to 33.8±11.9, with significant difference in IRA TIMI and CTFC between groups （P〈0.01）. CONCLUSION： Super-selective injection of 100 μg nitroprusside in IRA effectively improved no-reflow phenomenon in primary PCI of AMI.

关 键 词：主动脉脉压 颈动脉斑块 冠状动脉病变积分 

分 类 号：R541.4[医药卫生—心血管疾病]